Physical Activity Maintenance: A Critical Narrative Review and Directions for Future Research.

2021 
A clear rationale can be made for promoting long-term regular physical activity (PA), yet despite some attempts to operationalize "maintenance," no robust definition has been agreed upon, beyond arbitrary time frames of regular PA. This has likely impaired the advancement of theory and practice. The purpose of this critical narrative review was to first overview the conception of maintenance and co-requisite theoretical constructs in theories used in PA research. Our subsequent aims were to engage in a critical analysis of this literature to propose a working definition of PA maintenance followed by recommendations for future research. Relevant behavioral theories were parsed for references to maintenance or maintenance-specific constructs and constructs most likely associated with maintenance were overviewed from a recent systematic review. Based on this information, we suggest PA maintenance be operationalized as a process marked by a shift in the mechanisms of action determining behavioral performance, that engender greater perceived behavioral enactment efficiency. We suggest that maintenance should not be considered an absolute state of behavioral performance (e.g., a stage), as some constructs that were critical to behavioral performance during initiation will still be critical during PA continuation. Based on this definition, we propose a method of falsifiability hypothesis testing of theoretical constructs that may determine the maintenance process. Finally, the review concludes with suggestions for future research using this operationalization of maintenance including measure development, tests of latency to reach the peak maintenance process, validating constructs critical to determining maintenance, exploration of the contextual and individual moderators of maintenance formation, and the development of an omnibus dynamic model of initiation, continuation, and maintenance in PA behavior change.
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